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WO1996030003A1 - Medicaments pour le traitement selectif des tissus affectes par des tumeurs - Google Patents

Medicaments pour le traitement selectif des tissus affectes par des tumeurs Download PDF

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Publication number
WO1996030003A1
WO1996030003A1 PCT/DE1996/000539 DE9600539W WO9630003A1 WO 1996030003 A1 WO1996030003 A1 WO 1996030003A1 DE 9600539 W DE9600539 W DE 9600539W WO 9630003 A1 WO9630003 A1 WO 9630003A1
Authority
WO
WIPO (PCT)
Prior art keywords
compound
compound according
substance
medicament
compounds
Prior art date
Application number
PCT/DE1996/000539
Other languages
German (de)
English (en)
Inventor
Werner Kreutz
Original Assignee
Werner Kreutz
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Werner Kreutz filed Critical Werner Kreutz
Priority to EP96907292A priority Critical patent/EP0817623B1/fr
Priority to US08/930,488 priority patent/US5985927A/en
Priority to DE59610819T priority patent/DE59610819D1/de
Priority to AU50996/96A priority patent/AU5099696A/en
Priority to AT96907292T priority patent/ATE253902T1/de
Priority to DE19680202T priority patent/DE19680202D2/de
Priority to JP8528780A priority patent/JPH11507326A/ja
Publication of WO1996030003A1 publication Critical patent/WO1996030003A1/fr

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/21Esters, e.g. nitroglycerine, selenocyanates
    • A61K31/215Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids
    • A61K31/235Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids having an aromatic ring attached to a carboxyl group
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/045Hydroxy compounds, e.g. alcohols; Salts thereof, e.g. alcoholates
    • A61K31/05Phenols
    • A61K31/06Phenols the aromatic ring being substituted by nitro groups
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/185Acids; Anhydrides, halides or salts thereof, e.g. sulfur acids, imidic, hydrazonic or hydroximic acids
    • A61K31/19Carboxylic acids, e.g. valproic acid
    • A61K31/192Carboxylic acids, e.g. valproic acid having aromatic groups, e.g. sulindac, 2-aryl-propionic acids, ethacrynic acid 
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/185Acids; Anhydrides, halides or salts thereof, e.g. sulfur acids, imidic, hydrazonic or hydroximic acids
    • A61K31/19Carboxylic acids, e.g. valproic acid
    • A61K31/195Carboxylic acids, e.g. valproic acid having an amino group
    • A61K31/196Carboxylic acids, e.g. valproic acid having an amino group the amino group being directly attached to a ring, e.g. anthranilic acid, mefenamic acid, diclofenac, chlorambucil
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/21Esters, e.g. nitroglycerine, selenocyanates
    • A61K31/215Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids
    • A61K31/22Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids of acyclic acids, e.g. pravastatin
    • A61K31/222Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids of acyclic acids, e.g. pravastatin with compounds having aromatic groups, e.g. dipivefrine, ibopamine
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P35/00Antineoplastic agents
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P43/00Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00

Definitions

  • the invention relates to new drugs that selectively fight tumor tissue, while healthy tissue is practically not attacked.
  • the new drugs are therefore ideal for cancer therapy.
  • That tumor tissue in the extracellular milieu has a lowered mean pH of about 6.5 to 7.0 and the pH on the cancer cell surface can even drop to 5, while the pH in normal tissue and in the blood about 7.2 to 7.5 is known and is described, for example, in DE-A 44 07 484 and in Tumor Biol., 1994, 15: 304-310.
  • These publications disclose that by lowering the - 2 -
  • DE-A 44 07 484 therefore proposes to bring the acidic external environment of cancer cells to the normal physiological pH level of 7 to 7.5 and thereby to fight the cancer cells through the body's own immune system.
  • the acidic external environment of cancer cells is brought to a physiological pH of 7 to 7.5 either by artificial alkalization or by preventing the acidification process itself.
  • the protonated compounds can act in various ways. After protonation has taken place, the compounds can permeate reversibly through the tumor cell membrane and in this way, as proton carriers, break down the proton gradient across the tumor cell membrane. The result is an increase in the extracellular pH value and a decrease in the pH value inside the cell, which can lead to the cell death of the cancer cell. As a side effect, such substances, in addition to their damaging effect on the cancer cell, initiate the natural immune defense reaction by increasing the pH in the outside environment, as described in DE-A 44 07 484. It is also possible to use compounds which do not move across the membrane from the aqueous outer phase of the membrane into the aqueous inner phase, but rather substances which are built into the membrane and enable proton transfer through the membrane. Such compounds form a defined pore for protons, i.e. they allow free or only slightly restricted diffusion of protons in the direction of their concentration gradient.
  • the compounds particularly preferably have toxic properties after their protonation in an acidic environment and act as cell poisons.
  • Compounds which are preferred according to the invention for use as a pharmaceutical have parts of the molecule which are protonated at a pH of less than 7, preferably less than 6.5 and in this protonated state become toxic to cancer cells. Protonation is preferably carried out at a pH of more than 5, particularly preferably more than 6.
  • the compounds preferably have a dissociation equilibrium in order to ensure reversible protonation at the desired pH.
  • the compounds according to the invention must also be physiologically tolerable in the concentration range of activity, the toxicity limit preferably being between 200 mg / kg body weight / day and 400 mg / kg body weight / day.
  • the compounds according to the invention for use as a pharmaceutical should have a suitable water solubility, which is preferably at least about 20 mg / ml, particularly preferably at least 30 mg / ml.
  • the proportion of dead cells is detected by propidium iodide staining, in the XTT method by converting XTT through the mitochondrial dehydrogenase to formazan.
  • the methods are described, for example, in Tumor Biologie 1994, 15, 304 and in the biochemical catalog from Boehringer Mannheim, Germany 0392.C 73.3.1465554 1 CB, Cat. No. 1465 015.
  • pH-sensitive toxic substances selected substances are allowed to act on both tumor cell lines and MNCs at various predetermined pH values, for example at pH 5.5, 6.0, 6.5, 7.0 and 7.5. e.g. 4 hours and 24 hours to then measure the number of cancer cells or MNCs killed.
  • control measurements are carried out without adding pK-sensitive substances.
  • Substances are suitable for therapeutic purposes if they have a toxic effect on cancer cells according to the pH characteristics and have no or only minor toxicity on MNCs and erythrocytes in the pH range of pH> 7.
  • each type of tumor has an intrinsic mean intercellular pH, e.g. is about 6.7 for breast tumors and about 6.9 for colon tumors.
  • the pH values in the extracellular tumor tissue can be lowered by approx. 0.5 pH units. by inducing acidosis through glucose administration.
  • Compounds suitable according to the invention are, for example, compounds having an aromatic system and a conjugatively coupled carboxyl, hydroxyl, sulfo, and / or Amino group.
  • the aromatic system is preferably a phenyl or naphthyl group or a heteroaromatic system with 5 to 10 atoms, preferably 1 or 2 atoms representing heteroatoms, preferably nitrogen or oxygen atoms. Pyridine can be mentioned as an example.
  • the aromatic system is particularly preferably a phenyl group.
  • the aromatic system carries substituents which, through their inductive or mesomeric effect, suitably change the dissociation constant of the carboxyl, amino, sulfo or hydroxyl group, so that protonation or deprotonation takes place in the desired pH range.
  • substituents which, through their inductive or mesomeric effect, suitably change the dissociation constant of the carboxyl, amino, sulfo or hydroxyl group, so that protonation or deprotonation takes place in the desired pH range.
  • dissociation constant is increased or decreased by suitable substitution of an aromatic system is known and can be found in general textbooks of organic chemistry.
  • Salicylic acid and acetylsalicylic acid are not preferred according to the invention.
  • X is a carboxyl, hydroxyl, sulfo and / or amino group
  • the radicals R independently represent any substituents which are chosen so that the dissociation constant for group X is in the desired pH range and n is an integer from 1 to 5.
  • X preferably represents a carboxyl or hydroxyl group, and the radicals R as a whole preferably provide an electron-withdrawing effect.
  • Suitable radicals R are, for example, amino, hydroxyl, optionally with substituted amino, nitro and cyano groups, halogen atoms, in particular fluorine or chlorine atoms, alkoxy radicals with up to 10 carbon atoms and ester or sulfonate radicals with up to 10 carbon atoms.
  • the radicals R are chosen such that the radical X is deprotonated at a pH of more than 7 (or is present as -NH 2 in the case of an amino group) and protonated in the desired pH range, for example at about 6.5 becomes.
  • the compound is selected using the routine procedures described above so that it has a significantly lower cytotoxicity in the deprotonated state than in the protonated state.
  • 2 or more compounds according to the invention are used in a mixture, or are administered in succession at such short time intervals that their effects complement one another appropriately.
  • FIG. 1A shows the effectiveness of the 4-succinic acid ester of 2,4-dihydroxybenzoic acid on K-562 cancer cells. It becomes clear that the toxicity effect starts at about pH 6.5 and reaches its maximum at pH 5.7.
  • Figure IB shows the mode of action of the same compound on mononuclear blood cells (MNC's). At an extracellular pH in the range of 7.2 to 7.4, as is the case with normal tissue and blood cells, no significant toxicity can be determined.
  • MNC's mononuclear blood cells
  • FIG. 2A shows the effect of trans-3,4-difluorocinnamic acid on K-562 cells. It becomes clear that a significant cytotoxic effect only occurs at an extracellular pH value of less than 6.5.
  • Figure 2B shows the effect of the same compound on MNC's.
  • mice are implanted with a small cell lung tumor (LXFS 650), the extracellular pH of about 6.9 is close to the physiological pH of 7.2-7.3.
  • LXFS 650 small cell lung tumor
  • 2,4-dihydroxybenzoic acid (substance (1)) is used as the therapeutic substance.
  • 3-4 weeks after the tumor has been implanted 15 mice bearing tumors of 5-7mm in diameter are divided into 3 groups: the first group of 5 is managed as a control group without therapy, the second group of 5 is the Substance (1) at a concentration of 200 mg / kg / day and in the third group of 5 at a concentration of 400 mg / kg / day injected into the tail vein.
  • 4 injections into the tail vein were carried out on 4 consecutive days.
  • the resulting venous damage did not allow further injections.
  • the tumor volumes were determined on the 7th, 10th, 14th and 17th day. From Fig. 4 it can be seen that at a concentration of 400 mg / kg / day after the 7th day a growth arrest is achieved until the 10th day, after which the tumor begins to grow again since the therapy has not been continued. At 200 mg / kg / day, a weak effect only begins on the 10th day.
  • the compounds according to the invention can be formulated in a manner known per se into medicaments for mammals, preferably humans. They are in the drugs Compounds according to the invention in admixture with a pharmaceutical organic or inorganic carrier which is suitable for enteral or parenteral administrations. Oral administration of the compound according to the invention via tablets, capsules, powder or in liquid form, such as suspensions, in solution, as an emulsion or as a syrup, is particularly preferred.
  • common pharmaceutical carriers such as sodium citrate, lactose, microcrystalline cellulose and starch, lubricants such as anhydrous silica, hydrogenated castor oil, magnesium stearate, sodium lauryl sulfate and talc, and binders such as starch paste, glucose, lactose, gum arabic, mannitol, magnesium trisilicate and talc used.
  • customary liquid carriers can be used.
  • the dosage form of the compound according to the invention depends very much on the specific compound and can be determined by a person skilled in the art on the basis of the condition of the patient to be treated, the severity and type of the disease to be treated, and possible side effects of the substance administered.

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  • Health & Medical Sciences (AREA)
  • Chemical & Material Sciences (AREA)
  • Medicinal Chemistry (AREA)
  • Pharmacology & Pharmacy (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Epidemiology (AREA)
  • Emergency Medicine (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • General Chemical & Material Sciences (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Organic Chemistry (AREA)
  • Engineering & Computer Science (AREA)
  • Bioinformatics & Cheminformatics (AREA)
  • Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
  • Acyclic And Carbocyclic Compounds In Medicinal Compositions (AREA)
  • Medicines Containing Antibodies Or Antigens For Use As Internal Diagnostic Agents (AREA)
  • Medicines Containing Material From Animals Or Micro-Organisms (AREA)
  • Medicines That Contain Protein Lipid Enzymes And Other Medicines (AREA)

Abstract

L'invention a pour objet des médicaments présentant un fort effet cytotoxique qui s'exerce largement sélectivement sur des tissus affectés par des tumeurs. L'invention repose sur le fait que le milieu extérieur de cellules cancéreuses se situe dans une plage acide de pH inférieure à 7, alors que le pH physiologique est compris entre 7 et 7,5. L'invention a donc pour objet des composés utilisables comme principe actif thérapeutique, qui sont protonés à un pH inférieur à 7 ou qui libèrent une substance à un tel pH, le composé protoné ou la substance libérée exerçant sur les cellules un effet plus fortement destructeur que le composé non protoné ou que le composé avant libération de la substance. Les composés selon l'invention sont protonés ou décomposés dans le milieu extérieur acide des cellules tumorales, exerçant ainsi sur ces dernières un effet destructeur.
PCT/DE1996/000539 1995-03-30 1996-03-22 Medicaments pour le traitement selectif des tissus affectes par des tumeurs WO1996030003A1 (fr)

Priority Applications (7)

Application Number Priority Date Filing Date Title
EP96907292A EP0817623B1 (fr) 1995-03-30 1996-03-22 Medicaments pour le traitement selectif des tissus affectes par des tumeurs
US08/930,488 US5985927A (en) 1995-03-30 1996-03-22 Medicaments for the selective treatment of tumor tissues
DE59610819T DE59610819D1 (de) 1995-03-30 1996-03-22 Arzneistoffe zur selektiven bekämpfung von tumorgewebe
AU50996/96A AU5099696A (en) 1995-03-30 1996-03-22 Medicaments for the selective treatment of tumour tissues
AT96907292T ATE253902T1 (de) 1995-03-30 1996-03-22 Arzneistoffe zur selektiven bekämpfung von tumorgewebe
DE19680202T DE19680202D2 (de) 1995-03-30 1996-03-22 Arzneistoffe zur selektiven Bekämpfung von Tumorgewebe
JP8528780A JPH11507326A (ja) 1995-03-30 1996-03-22 腫瘍組織の選択的治療用医薬物質

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE19511623 1995-03-30
DE19511623.2 1995-03-30

Publications (1)

Publication Number Publication Date
WO1996030003A1 true WO1996030003A1 (fr) 1996-10-03

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Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/DE1996/000539 WO1996030003A1 (fr) 1995-03-30 1996-03-22 Medicaments pour le traitement selectif des tissus affectes par des tumeurs

Country Status (7)

Country Link
US (1) US5985927A (fr)
EP (1) EP0817623B1 (fr)
JP (1) JPH11507326A (fr)
AT (1) ATE253902T1 (fr)
AU (1) AU5099696A (fr)
DE (2) DE19680202D2 (fr)
WO (1) WO1996030003A1 (fr)

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1998058639A1 (fr) * 1997-06-24 1998-12-30 Werner Kreutz Compositions a effet synergique pour lutter selectivement contre les tissus tumoraux
WO2000025763A3 (fr) * 1998-10-30 2000-11-09 Meckel Spenglersan Gmbh Agents exerçant un effet inhibiteur de proliferation sur des cellules tumorales
US6727235B2 (en) 1997-06-24 2004-04-27 Werner Kreutz Synergistic compositions for the selective control of tumor tissue
EP2870966A1 (fr) 2013-11-07 2015-05-13 Werner Kreutz Salicylates pour l'utilisation dans le traitement du cancer

Families Citing this family (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
TWI249519B (en) 2000-08-29 2006-02-21 Nobex Corp Immunoregulatory compounds and derivatives and methods of treating diseases therewith
CA2359812C (fr) 2000-11-20 2004-02-10 The Procter & Gamble Company Formes posologiques pharmaceutiques a couches multiples permettant de reduire l'impact des revetement fractures
US8048924B2 (en) 2001-08-29 2011-11-01 Biocon Limited Methods and compositions employing 4-aminophenylacetic acid compounds
HUE028158T2 (en) 2004-07-07 2016-12-28 Biocon Ltd Synthesis of bound immunoregulatory compounds

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1980000791A1 (fr) * 1978-10-13 1980-05-01 Schwimmer A Produits pharmaceutiques presentant une activite (beta)-glucuronidase et/ou a dependance du ph et leurs methodes de preparation et leur utilisation dans le traitement selectifs des maladies
US4724234A (en) * 1982-09-17 1988-02-09 Therapeutical Systems Corp. Method for producing oncolysis
WO1994027584A2 (fr) * 1993-05-21 1994-12-08 Radopath Limited Medicaments d'arylation
DE4407484A1 (de) * 1993-12-03 1995-06-08 Werner Prof Dr Kreutz Medikament zur Krebs-Therapie
WO1995024897A1 (fr) * 1994-03-17 1995-09-21 Radopath Limited Agents antiviraux et anticancereux

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US3914324A (en) * 1971-07-17 1975-10-21 Brichima Spa Process for the preparation of diphenols

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1980000791A1 (fr) * 1978-10-13 1980-05-01 Schwimmer A Produits pharmaceutiques presentant une activite (beta)-glucuronidase et/ou a dependance du ph et leurs methodes de preparation et leur utilisation dans le traitement selectifs des maladies
US4724234A (en) * 1982-09-17 1988-02-09 Therapeutical Systems Corp. Method for producing oncolysis
WO1994027584A2 (fr) * 1993-05-21 1994-12-08 Radopath Limited Medicaments d'arylation
DE4407484A1 (de) * 1993-12-03 1995-06-08 Werner Prof Dr Kreutz Medikament zur Krebs-Therapie
WO1995024897A1 (fr) * 1994-03-17 1995-09-21 Radopath Limited Agents antiviraux et anticancereux

Non-Patent Citations (9)

* Cited by examiner, † Cited by third party
Title
CESK. FARM., vol. 41, no. 4-5, 1992, pages 127 - 129 *
DIALOG (R) FILE 399: CA SEARCH (R), ACCESSION NUMBER 117204558, XP002011866 *
J.ULRICHOVÁ ET AL.: "Cytoprotective effect of phenolics from Colchicum on rat hepatocytes", FITOTERAPIA, vol. 66, no. 5, 1995, pages 399 - 402, XP000579659 *
M.S.ANDERSON ET AL.: "Enhancement of Merocyanine 540-mediated Phototherapy by Salicylate", CANCER RES., vol. 53, no. 4, 15 February 1993 (1993-02-15), pages 806 - 809, XP000579667 *
M.TRAUTMANN ET AL.: "Aspirin-like drugs, ethanol-induced rat gastric injury and mucosal eicosanoid release", EUR.J.PHARMACOL., vol. 201, no. 1, 1991, pages 53 - 58, XP000579658 *
P.M.LOISEAU ET AL.: "Plasmodium berghei mouse model: antimalarial activity of new alkaloid salts of thiosemicarbazone and acridine derivatives", TROPICAL MEDICINE AND INTERNATIONAL HEALTH, vol. 1, no. 3, June 1996 (1996-06-01), pages 379 - 384, XP000579657 *
S.BUDAVARI ET AL., ED.: "THE MERCK INDEX, 11th Edition", 1989, MERCK & CO., INC., RAHWAY, N.J., U.S.A., XP002011867 *
S.INAYAMA ET AL.: "Studies on Non-sesquiterpenoid Constituents of Gaillardia pulchella. II. Less Lipophilic Substances, Methyl Caffeate as an Antitumor Catecholic", CHEM.PHARM.BULL., vol. 32, no. 3, 1984, pages 1135 - 1141, XP002011865 *
T.SEVERIN ET AL.: "pH-Dependent LAK Cell Cytotoxicity", TUMOR BIOL., vol. 15, September 1994 (1994-09-01), pages 304 - 310, XP000577049 *

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1998058639A1 (fr) * 1997-06-24 1998-12-30 Werner Kreutz Compositions a effet synergique pour lutter selectivement contre les tissus tumoraux
DE19726871C1 (de) * 1997-06-24 1999-03-04 Werner Kreutz Synergistisch wirkende Zusammensetzungen zur selektiven Bekämpfung von Tumorgewebe
US6395720B1 (en) 1997-06-24 2002-05-28 Werner Kreutz Synergistically acting compositions for selectively combating tumor tissue
US6727235B2 (en) 1997-06-24 2004-04-27 Werner Kreutz Synergistic compositions for the selective control of tumor tissue
US7183269B2 (en) 1997-06-24 2007-02-27 Werner Kreutz Synergistic compositions for the selective control of tumor tissue
WO2000025763A3 (fr) * 1998-10-30 2000-11-09 Meckel Spenglersan Gmbh Agents exerçant un effet inhibiteur de proliferation sur des cellules tumorales
EP2870966A1 (fr) 2013-11-07 2015-05-13 Werner Kreutz Salicylates pour l'utilisation dans le traitement du cancer

Also Published As

Publication number Publication date
DE19680202D2 (de) 1997-08-21
EP0817623B1 (fr) 2003-11-12
DE59610819D1 (de) 2003-12-18
JPH11507326A (ja) 1999-06-29
US5985927A (en) 1999-11-16
EP0817623A1 (fr) 1998-01-14
ATE253902T1 (de) 2003-11-15
AU5099696A (en) 1996-10-16

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